A body cast or spica cast is used to immobilize the hips and thighs of a patient to assist in the healing of bones, muscles and tendons. Spica casts are typically used on children following surgery or a reduction to hold the hips in a position that facilitates bone growth. The casts may begin at the chest and extend to cover both legs down to the toes or knee, or one leg down to the toes or knee and the other leg down to the hip or knee. A similar type of cast known as an abduction boot extends from the upper thigh of each leg down to the foot.
Spica casts and abduction boots are customized for each patient depending on his or her body type and recovery needs. The casts are made from fiberglass or plaster, and a rigid bar is often placed between the legs to ensure immobility. The casts should be kept as dry as possible so that they do not cause skin irritation or lose their proper shape due to softening and cracking.
Spica casts typically contain an opening between the legs for the patient to use the bathroom. For infants and toddlers, a disposable diaper is tucked into the edges of this opening, a second diaper is placed on top of this diaper, and an additional bladder control diaper is placed on top of the second diaper. A material such as moleskin is often placed around the edges of the cast to help prevent the cast from soiling. The child's head should be elevated above his feet to assist in draining urine and stool away from the cast. The diaper and plastic wrap should be changed immediately after wetting to maintain the cast's integrity. Older children can be rolled onto their sides to use a bed pan or urinal, but soiling of the cast is still a problem. Sponge baths are the only form of bathing for children wearing spica casts. The child is generally restricted to lying in bed, and his or her position must be changed periodically throughout the day and night.